ADHD in Childhood — What We Missed at School
By now, we know ADHD isn’t new, and it isn’t just about willpower. In the last article, we explored how ADHD affects motivation, emotion, and attention at a neurological level, not because of laziness, but because of differences in how the brain processes stimulation and regulation. But these traits don’t begin in adulthood. To be diagnosed with ADHD, symptoms must have been present in childhood, not just emerging later due to stress or burnout. That’s part of the diagnostic criteria itself. And that’s what makes the school years so important in understanding our stories: it’s often where the patterns begin, even if no one noticed at the time.
I was born in 1975. Back then, ADHD wasn’t something most people, or teachers, talked about. It had only recently become diagnosable as “ADD with or without hyperactivity” in the DSM-III in 1980 (American Psychiatric Association, 1980), and even then, the focus was on obvious disruption — mostly in white schoolboys who couldn’t sit still. If you were distracted, emotional, slow to start tasks or fast to give up, that wasn’t framed as neurological. It was framed as character.
And if, like me, you changed schools a lot, nine different schools before university, thanks to my dad’s RAF career, the pattern was even easier to miss. Every new classroom was a fresh start, but also a fresh chance to fly under the radar. No one saw the whole picture. Not even me.
From a young age, I was labelled “bright but could try harder.” I did well in subjects I liked, but struggled to sustain effort in others. I made careless mistakes, lost track of instructions, got stuck starting, or finishing, even simple assignments. I didn’t know it then, but this was classic combined-type ADHD: executive dysfunction, distractibility, impulsivity, and a brain that was constantly on the move, even when I wasn’t. I managed to hold it together, just enough, but always with a nagging sense of underperformance. I wasn’t failing, but I wasn’t thriving either.
This pattern is common. Once in school, children with ADHD tend to perform worse academically and face more social challenges than their peers, including significant deficits in everyday social skills and emotion recognition (Haza et al., 2024). It’s not about not caring. It’s about being asked to run a marathon with untied laces.
And yet, these challenges are rarely recognised for what they are, especially in girls and more internalised presentations. Quinn and Madhoo (2014) found that girls with ADHD are significantly more likely to go undiagnosed, in part because their symptoms are less disruptive. Instead of blurting out answers, they zone out. Instead of climbing the walls, they people-please. Instead of failing tests, they overwork until they collapse. These children are praised for being polite or quiet, even as they silently burn out.
Many of us learn to mask. I did. I leaned into charm, humour, verbal fluency — anything that helped me pass as capable. I became the kid who did well *enough* without drawing attention. But masking isn’t coping, it’s camouflage. And over time, it takes a toll. What begins as effort turns into shame. Why can’t I just do the thing?
The explanations offered at the time weren’t helpful. Disorganisation? Just lazy. Emotional? Too sensitive. Fidgety? Too much sugar. Back then, it was easier to blame Ribena than recognise neurodivergence. But a meta-analysis of 23 controlled trials found no significant link between sugar consumption and hyperactivity in children (Wolraich et al., 1995). Still, these myths persist, often more firmly than the science.
As we explored in the first article, ADHD is highly heritable — most of us didn’t develop it randomly. We were born into neurodivergent families, often raised by parents who shared similar traits, whether diagnosed or not. And when everyone around you is wired differently, the signs don’t always stand out. That’s why many adults only recognise their own ADHD when their child is assessed. The pattern was there all along, it just looked normal.
It’s only in retrospect, through the lens of diagnosis, that I can see how clearly the criteria applied. According to the DSM-5, a diagnosis of ADHD requires at least six symptoms of inattention or hyperactivity–impulsivity, present before age 12, across multiple settings, and linked to functional impairment (American Psychiatric Association, 2013). In my case, every box was ticked — forgetfulness, distractibility, disorganisation, emotional reactivity, restlessness, impulsive interruptions. These weren’t isolated quirks. They were stable, observable traits. The only thing missing was recognition.
We can’t rewrite the past. We can’t change the curriculum we were shaped by. But we can name what was missing, and begin to understand why school felt so much harder than it looked from the outside.
Because we weren’t misbehaving. We were misunderstood.
Did school feel harder than it looked for you or someone you love?
American Psychiatric Association. (1980). *Diagnostic and statistical manual of mental disorders* (3rd ed.). Washington, DC.
American Psychiatric Association. (2013). *Diagnostic and statistical manual of mental disorders* (5th ed.). Arlington, VA: American Psychiatric Publishing.
Haza, B., Gosling, C. J., Ciminaghi, F., Conty, L., & Pinabiaux, C. (2024). Social cognition and everyday social skills in children and adolescents with ADHD: A meta-analysis of case–control studies. *Journal of Child Psychology and Psychiatry*. https://doi.org/10.1111/jcpp.14006
Nigg, J. T., Lewis, K., Edinger, T., & Falk, M. (2012). Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. *Journal of the American Academy of Child & Adolescent Psychiatry, 51*(1), 86–97.e8. https://doi.org/10.1016/j.jaac.2011.10.015
Quinn, P. O., & Madhoo, M. (2014). A review of ADHD in women and girls: Uncovering this hidden diagnosis. *The Primary Care Companion for CNS Disorders, 16*(3). https://doi.org/10.4088/PCC.13r01596
Wolraich, M. L., Wilson, D. B., & White, J. W. (1995). The effect of sugar on behavior or cognition in children: A meta-analysis. *JAMA, 274*(20), 1617–1621. https://doi.org/10.1001/jama.1995.03530200053037
